1Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
2Department of Preventive Medicine, Kyung Hee University School of Medicine, Seoul, Korea
3Ewha Institute of Convergence Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea
4Department of Occupational and Environment Medicine, Ewha Womans University College of Medicine, Seoul, Korea
5Department of Occupational and Environmental Medicine, Kyung Hee University Hospital, Seoul, Korea
6Department of Occupational and Environmental Medicine, Kyung Hee University School of Medicine, Seoul, Korea
Copyright © 2022 by the Korean Cancer Association
This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Ethical Statement
Ethics approvals for the study protocol and analysis of the data were obtained from the institutional review board of Kyung Hee University Hospital (No. 2018-12-020). The informed consent requirement was exempted by the institutional review board because researchers only accessed retrospectively a de-identified database for analysis purposes.
Author Contributions
Conceived and designed the analysis: Jung JY, Oh CM, Kim MH. Kim Y, Nam DJ.
Collected the data: Ryoo JH.
Contributed data or analysis tools: Ryoo JH, Ha E.
Performed the analysis: Ryoo JH, Ha E.
Wrote the paper: Park SK.
Conflicts of Interest
Conflict of interest relevant to this article was not reported.
Characteristic | Overall | Frequency of high intensity physical activity | ||||
---|---|---|---|---|---|---|
Group 1 (n=129,264) | Group 2 (n=66,580) | Group 3 (n=14,122) | Group 4 (n=10,391) | p for trenda) | ||
Person-year (total) | 965,829.1 | 566,486.9 | 291,642.6 | 61,965.9 | 45,733.7 | |
Person-year (average) | 4.38±0.45 | 4.38±0.49 | 4.38±0.38 | 4.39±0.37 | 4.40±0.46 | < 0.001 |
Age (yr) | 58.1±8.8 | 59.4±9.3 | 55.7±7.5 | 56.7±7.7 | 60.1±8.5 | < 0.001 |
Sex | ||||||
Male | 123,935 (56.2) | 61,919 (47.9) | 46,173 (69.4) | 9,224 (65.3) | 6,619 (63.7) | < 0.001 |
Female | 96,422 (43.8) | 67,345 (52.1) | 20,407 (30.6) | 4,898 (34.7) | 3,772 (36.3) | |
BMI (kg/m2) | 24.0±2.9 | 23.9±3.0 | 24.1±2.8 | 24.1±2.7 | 24.1±2.8 | < 0.001 |
WC (cm) | 82.0±8.2 | 81.7±8.4 | 82.5±7.9 | 82.1±7.9 | 82.6±7.9 | < 0.001 |
Systolic BP (mm Hg) | 125.3±15.2 | 125.4±15.5 | 124.9±14.6 | 125.3±14.6 | 126.2±15.1 | < 0.001 |
Diastolic BP (mm Hg) | 77.7±9.9 | 77.5±10.1 | 78.0±9.8 | 77.8±9.8 | 77.9±9.9 | 0.004 |
Total cholesterol (mg/dL) | 200.0±37.5 | 200.3±38.0 | 199.7±36.8 | 199.2±36.5 | 198.5±37.5 | < 0.001 |
Triglyceride (mg/dL) | 118 (83–170) | 118 (83–170) | 120 (84–174) | 111 (78–162) | 113 (79–163) | < 0.001 |
HDL-cholesterol (mg/dL) | 55.4±32.5 | 56.0±36.2 | 54.1±25.6 | 55.8±29.0 | 55.7±28.0 | 0.495 |
LDL-cholesterol (mg/dL) | 118.3±39.0 | 118.6±39.6 | 117.7±37.6 | 117.9±39.3 | 117.3±40.7 | 0.002 |
Fasting blood glucose (mg/dL) | 100.8±25.4 | 100.5±25.6 | 101.0±25.3 | 101.2±24.2 | 102.0±24.8 | < 0.001 |
SCr (mg/dL) | 1.15±1.49 | 1.06±1.25 | 1.31±1.83 | 1.26±1.72 | 1.11±1.27 | 0.091 |
eGFR (mL/min/1.73 m2) | 80.6±20.2 | 80.8±19.4 | 80.4±21.7 | 80.2±21.2 | 79.8±18.8 | < 0.001 |
AST (U/L) | 26.6±16.5 | 26.5±17.1 | 26.7±15.4 | 26.8±14.4 | 27.3±18.2 | < 0.001 |
ALT (U/L) | 25.4±19.4 | 24.9±19.2 | 26.3±19.8 | 25.5±18.9 | 25.1±18.9 | 0.659 |
GGT (U/L) | 39.1±53.9 | 37.5±54.6 | 42.0±52.2 | 39.2±52.4 | 39.6±57.8 | 0.036 |
Smoking amount (pack-year) | 7.8±13.9 | 7.1±14.1 | 8.9±13.4 | 8.2±13.2 | 8.1±14.6 | < 0.001 |
Alcohol drinker (%) | 14.3 | 12.4 | 16.4 | 18.2 | 19.4 | < 0.001 |
Incidence of pancreatic cancer (%) | 377 (0.17) | 244 (0.19) | 107 (0.16) | 16 (0.11) | 10 (0.10) | < 0.001 |
Duration of PA (mo) | 30.8±10.9 | 30.7±12.2 | 31.4±11.4 | 29.5±9.8 | 27.6±10.3 | < 0.001 |
MET (min/wk) | 874±346 | 817±330 | 932±294 | 1,231±382 | 1,527±419 | < 0.001 |
Sitting time (hr/day) | 7.1±3.4 | 7.2±3.6 | 6.9±3.1 | 7.0±2.9 | 7.1±3.5 | 0.065 |
Moderate intensity PA | ||||||
Number (wk) | 2.8±1.3 | 2.6±1.1 | 2.9±1.4 | 2.4±1.5 | 2.2±1.7 | < 0.001 |
Minutes | 25.9±8.1 | 27.9±7.5 | 28.6±9.4 | 27.5±10.3 | 25.4±11.2 | < 0.001 |
Values are presented as mean±standard deviation or number (%). Group 1, performing 0 day per week; group 2, performing 1-3 days per week; group 3, performing 4-5 days per week; group 4, performing 6-7 days per week. ALT, alanine aminotransferase; AST, aspartate aminotransferase; BMI, body mass index; BP, blood pressure; eGFR, estimated glomerular filtration rate; GGT, γ-glutamyltransferase; HDL, high-density lipoprotein; LDL, low-density lipoprotein; MET, metabolic equivalent of task; PA, physical activity; SCr, serum creatinine; WC, waist circumference.
a) p-value by ANOVA-test for continuous variables and chi-square test for categorical variables.
Characteristic | Participants without pancreatic cancer (n=219,980) | Participants with pancreatic cancer (n=377) | p-valuea) |
---|---|---|---|
Person-year (average) | 4.39±0.44 | 2.59±1.24 | < 0.001 |
Age (yr) | 58.1±8.8 | 64.8±10.1 | < 0.001 |
Sex | |||
Male | 123,690 (56.2) | 245 (65.0) | < 0.001 |
Female | 96,290 (43.8) | 132 (35.0) | |
BMI (kg/m2) | 24.0±2.9 | 23.9±2.8 | 0.803 |
WC (cm) | 82.0±8.2 | 83.5±7.8 | < 0.001 |
Systolic BP (mm Hg) | 125.3±15.2 | 127.7±15.5 | 0.003 |
Diastolic BP (mm Hg) | 77.7±9.9 | 77.7±10.1 | 0.934 |
Total cholesterol (mg/dL) | 200.0±37.5 | 195.1±37.5 | 0.011 |
Triglyceride (mg/dL) | 141.6±93.8 | 146.8±92.9 | 0.288 |
HDL-cholesterol (mg/dL) | 55.4±32.5 | 51.0±12.9 | < 0.001 |
LDL-cholesterol (mg/dL) | 118.3±39.0 | 115.6±37.6 | 0.180 |
Fasting blood glucose (mg/dL) | 100.8±25.4 | 109.9±35.7 | < 0.001 |
SCr (mg/dL) | 1.15±1.49 | 1.19±1.55 | 0.615 |
eGFR (mL/min/1.73 m2) | 80.6±20.2 | 75.8±19.3 | < 0.001 |
AST (U/L) | 26.6±16.4 | 29.3±32.2 | 0.002 |
ALT (U/L) | 25.4±19.3 | 26.0±17.3 | 0.482 |
GGT (U/L) | 39.0±53.8 | 51.6±85.3 | 0.004 |
Smoking amount (pack-year) | 7.8±13.9 | 11.6±20.8 | < 0.001 |
Alcohol drinker (%) | 14.3 | 19.1 | 0.009 |
MET (min/wk) | 874±378 | 858±345 | < 0.001 |
Sitting time | 7.1±3.6 | 7.1±3.8 | 0.104 |
Moderate intensity PA | |||
Number (wk) | 2.8±1.4 | 2.3±1.2 | < 0.001 |
Minutes | 26.0±8.6 | 25.7±9.1 | < 0.001 |
Values are presented as mean±standard deviation or number (%). ALT, alanine aminotransferase; AST, aspartate aminotransferase; BMI, body mass index; BP, blood pressure; eGFR, estimated glomerular filtration rate; GGT, γ-glutamyltransferase; HDL, high-density lipoprotein; LDL, low-density lipoprotein; MET, metabolic equivalent of task; PA, physical activity; SCr, serum creatinine; WC, waist circumference.
a) p-value by t-test for continuous variables and chi-square test for categorical variables.
Incidence density: number of incident pancreatic cancer per 10,000 person-year. Adjusted model: multivariate adjustment for age, sex, BMI, systolic BP, fasting blood glucose, LDL-cholesterol, eGFR, GGT, smoking amount (pack-year), and alcohol intake. Group 1, performing 0 day per week; group 2, performing 1-3 days per week; group 3, performing 4-5 days per week; group 4, performing 6-7 days per week. BMI, body mass index; BP, blood pressure; eGFR, estimated glomerular filtration rate; GGT, γ-glutamyltransferase; LDL, lowdensity lipoprotein.
Baseline characteristics of participants according to the four groups of the physical activity levels (n=220,357)
Characteristic | Overall | Frequency of high intensity physical activity | ||||
---|---|---|---|---|---|---|
Group 1 (n=129,264) | Group 2 (n=66,580) | Group 3 (n=14,122) | Group 4 (n=10,391) | p for trend | ||
Person-year (total) | 965,829.1 | 566,486.9 | 291,642.6 | 61,965.9 | 45,733.7 | |
Person-year (average) | 4.38±0.45 | 4.38±0.49 | 4.38±0.38 | 4.39±0.37 | 4.40±0.46 | < 0.001 |
Age (yr) | 58.1±8.8 | 59.4±9.3 | 55.7±7.5 | 56.7±7.7 | 60.1±8.5 | < 0.001 |
Sex | ||||||
Male | 123,935 (56.2) | 61,919 (47.9) | 46,173 (69.4) | 9,224 (65.3) | 6,619 (63.7) | < 0.001 |
Female | 96,422 (43.8) | 67,345 (52.1) | 20,407 (30.6) | 4,898 (34.7) | 3,772 (36.3) | |
BMI (kg/m2) | 24.0±2.9 | 23.9±3.0 | 24.1±2.8 | 24.1±2.7 | 24.1±2.8 | < 0.001 |
WC (cm) | 82.0±8.2 | 81.7±8.4 | 82.5±7.9 | 82.1±7.9 | 82.6±7.9 | < 0.001 |
Systolic BP (mm Hg) | 125.3±15.2 | 125.4±15.5 | 124.9±14.6 | 125.3±14.6 | 126.2±15.1 | < 0.001 |
Diastolic BP (mm Hg) | 77.7±9.9 | 77.5±10.1 | 78.0±9.8 | 77.8±9.8 | 77.9±9.9 | 0.004 |
Total cholesterol (mg/dL) | 200.0±37.5 | 200.3±38.0 | 199.7±36.8 | 199.2±36.5 | 198.5±37.5 | < 0.001 |
Triglyceride (mg/dL) | 118 (83–170) | 118 (83–170) | 120 (84–174) | 111 (78–162) | 113 (79–163) | < 0.001 |
HDL-cholesterol (mg/dL) | 55.4±32.5 | 56.0±36.2 | 54.1±25.6 | 55.8±29.0 | 55.7±28.0 | 0.495 |
LDL-cholesterol (mg/dL) | 118.3±39.0 | 118.6±39.6 | 117.7±37.6 | 117.9±39.3 | 117.3±40.7 | 0.002 |
Fasting blood glucose (mg/dL) | 100.8±25.4 | 100.5±25.6 | 101.0±25.3 | 101.2±24.2 | 102.0±24.8 | < 0.001 |
SCr (mg/dL) | 1.15±1.49 | 1.06±1.25 | 1.31±1.83 | 1.26±1.72 | 1.11±1.27 | 0.091 |
eGFR (mL/min/1.73 m2) | 80.6±20.2 | 80.8±19.4 | 80.4±21.7 | 80.2±21.2 | 79.8±18.8 | < 0.001 |
AST (U/L) | 26.6±16.5 | 26.5±17.1 | 26.7±15.4 | 26.8±14.4 | 27.3±18.2 | < 0.001 |
ALT (U/L) | 25.4±19.4 | 24.9±19.2 | 26.3±19.8 | 25.5±18.9 | 25.1±18.9 | 0.659 |
GGT (U/L) | 39.1±53.9 | 37.5±54.6 | 42.0±52.2 | 39.2±52.4 | 39.6±57.8 | 0.036 |
Smoking amount (pack-year) | 7.8±13.9 | 7.1±14.1 | 8.9±13.4 | 8.2±13.2 | 8.1±14.6 | < 0.001 |
Alcohol drinker (%) | 14.3 | 12.4 | 16.4 | 18.2 | 19.4 | < 0.001 |
Incidence of pancreatic cancer (%) | 377 (0.17) | 244 (0.19) | 107 (0.16) | 16 (0.11) | 10 (0.10) | < 0.001 |
Duration of PA (mo) | 30.8±10.9 | 30.7±12.2 | 31.4±11.4 | 29.5±9.8 | 27.6±10.3 | < 0.001 |
MET (min/wk) | 874±346 | 817±330 | 932±294 | 1,231±382 | 1,527±419 | < 0.001 |
Sitting time (hr/day) | 7.1±3.4 | 7.2±3.6 | 6.9±3.1 | 7.0±2.9 | 7.1±3.5 | 0.065 |
Moderate intensity PA | ||||||
Number (wk) | 2.8±1.3 | 2.6±1.1 | 2.9±1.4 | 2.4±1.5 | 2.2±1.7 | < 0.001 |
Minutes | 25.9±8.1 | 27.9±7.5 | 28.6±9.4 | 27.5±10.3 | 25.4±11.2 | < 0.001 |
Values are presented as mean±standard deviation or number (%). Group 1, performing 0 day per week; group 2, performing 1-3 days per week; group 3, performing 4-5 days per week; group 4, performing 6-7 days per week. ALT, alanine aminotransferase; AST, aspartate aminotransferase; BMI, body mass index; BP, blood pressure; eGFR, estimated glomerular filtration rate; GGT, γ-glutamyltransferase; HDL, high-density lipoprotein; LDL, low-density lipoprotein; MET, metabolic equivalent of task; PA, physical activity; SCr, serum creatinine; WC, waist circumference.
a)p-value by ANOVA-test for continuous variables and chi-square test for categorical variables.
Comparison between participants with and without incident pancreatic cancer
Characteristic | Participants without pancreatic cancer (n=219,980) | Participants with pancreatic cancer (n=377) | p-value |
---|---|---|---|
Person-year (average) | 4.39±0.44 | 2.59±1.24 | < 0.001 |
Age (yr) | 58.1±8.8 | 64.8±10.1 | < 0.001 |
Sex | |||
Male | 123,690 (56.2) | 245 (65.0) | < 0.001 |
Female | 96,290 (43.8) | 132 (35.0) | |
BMI (kg/m2) | 24.0±2.9 | 23.9±2.8 | 0.803 |
WC (cm) | 82.0±8.2 | 83.5±7.8 | < 0.001 |
Systolic BP (mm Hg) | 125.3±15.2 | 127.7±15.5 | 0.003 |
Diastolic BP (mm Hg) | 77.7±9.9 | 77.7±10.1 | 0.934 |
Total cholesterol (mg/dL) | 200.0±37.5 | 195.1±37.5 | 0.011 |
Triglyceride (mg/dL) | 141.6±93.8 | 146.8±92.9 | 0.288 |
HDL-cholesterol (mg/dL) | 55.4±32.5 | 51.0±12.9 | < 0.001 |
LDL-cholesterol (mg/dL) | 118.3±39.0 | 115.6±37.6 | 0.180 |
Fasting blood glucose (mg/dL) | 100.8±25.4 | 109.9±35.7 | < 0.001 |
SCr (mg/dL) | 1.15±1.49 | 1.19±1.55 | 0.615 |
eGFR (mL/min/1.73 m2) | 80.6±20.2 | 75.8±19.3 | < 0.001 |
AST (U/L) | 26.6±16.4 | 29.3±32.2 | 0.002 |
ALT (U/L) | 25.4±19.3 | 26.0±17.3 | 0.482 |
GGT (U/L) | 39.0±53.8 | 51.6±85.3 | 0.004 |
Smoking amount (pack-year) | 7.8±13.9 | 11.6±20.8 | < 0.001 |
Alcohol drinker (%) | 14.3 | 19.1 | 0.009 |
MET (min/wk) | 874±378 | 858±345 | < 0.001 |
Sitting time | 7.1±3.6 | 7.1±3.8 | 0.104 |
Moderate intensity PA | |||
Number (wk) | 2.8±1.4 | 2.3±1.2 | < 0.001 |
Minutes | 26.0±8.6 | 25.7±9.1 | < 0.001 |
Values are presented as mean±standard deviation or number (%). ALT, alanine aminotransferase; AST, aspartate aminotransferase; BMI, body mass index; BP, blood pressure; eGFR, estimated glomerular filtration rate; GGT, γ-glutamyltransferase; HDL, high-density lipoprotein; LDL, low-density lipoprotein; MET, metabolic equivalent of task; PA, physical activity; SCr, serum creatinine; WC, waist circumference.
a)p-value by t-test for continuous variables and chi-square test for categorical variables.
Hazard ratios and 95% confidence intervals for the incidence of pancreatic cancer according to the four groups divided by the frequency of vigorous physical activity
Person-year | Incidence cases | Incidence density | Hazard ratios (95% confidence interval) | ||
---|---|---|---|---|---|
Unadjusted | Adjusted model | ||||
Physical activity | |||||
Group 1 | 566,486.9 | 244 | 4.3 | 1.00 (reference) | 1.00 (reference) |
Group 2 | 291,642.6 | 107 | 3.7 | 0.85 (0.68–1.07) | 1.10 (0.86–1.40) |
Group 3 | 61,965.9 | 16 | 2.6 | 0.60 (0.36–0.99) | 0.75 (0.45–1.25) |
Group 4 | 45,733.7 | 10 | 2.2 | 0.51 (0.27–0.95) | 0.47 (0.25–0.89) |
p for trend | 0.014 | 0.004 | |||
Age (yr) | - | - | - | - | 1.08 (1.07–1.09) |
Sex (female vs. male) | - | - | - | - | 0.73 (0.57–0.94) |
BMI (kg/m2) | - | - | - | - | 1.01 (0.97–1.04) |
Systolic BP (mm Hg) | - | - | - | - | 1.000 (0.992–1.006) |
Fasting blood glucose (mg/dL) | - | - | - | - | 1.007 (1.004–1.009) |
LDL-cholesterol (mg/dL) | - | - | - | - | 1.000 (0.997–1.003) |
eGFR (mL/min/1.73 m2) | - | - | - | - | 0.998 (0.993–1.003) |
GGT (U/L) | - | - | - | - | 1.002 (1.000–1.003) |
Smoking amount (pack-year) | - | - | - | - | 1.009 (1.003–1.015) |
Alcohol drinker (%) | - | - | - | - | 1.124 (0.844–1.497) |
Incidence density: number of incident pancreatic cancer per 10,000 person-year. Adjusted model: multivariate adjustment for age, sex, BMI, systolic BP, fasting blood glucose, LDL-cholesterol, eGFR, GGT, smoking amount (pack-year), and alcohol intake. Group 1, performing 0 day per week; group 2, performing 1-3 days per week; group 3, performing 4-5 days per week; group 4, performing 6-7 days per week. BMI, body mass index; BP, blood pressure; eGFR, estimated glomerular filtration rate; GGT, γ-glutamyltransferase; LDL, lowdensity lipoprotein.
Values are presented as mean±standard deviation or number (%). Group 1, performing 0 day per week; group 2, performing 1-3 days per week; group 3, performing 4-5 days per week; group 4, performing 6-7 days per week. ALT, alanine aminotransferase; AST, aspartate aminotransferase; BMI, body mass index; BP, blood pressure; eGFR, estimated glomerular filtration rate; GGT, γ-glutamyltransferase; HDL, high-density lipoprotein; LDL, low-density lipoprotein; MET, metabolic equivalent of task; PA, physical activity; SCr, serum creatinine; WC, waist circumference. p-value by ANOVA-test for continuous variables and chi-square test for categorical variables.
Values are presented as mean±standard deviation or number (%). ALT, alanine aminotransferase; AST, aspartate aminotransferase; BMI, body mass index; BP, blood pressure; eGFR, estimated glomerular filtration rate; GGT, γ-glutamyltransferase; HDL, high-density lipoprotein; LDL, low-density lipoprotein; MET, metabolic equivalent of task; PA, physical activity; SCr, serum creatinine; WC, waist circumference. p-value by t-test for continuous variables and chi-square test for categorical variables.
Incidence density: number of incident pancreatic cancer per 10,000 person-year. Adjusted model: multivariate adjustment for age, sex, BMI, systolic BP, fasting blood glucose, LDL-cholesterol, eGFR, GGT, smoking amount (pack-year), and alcohol intake. Group 1, performing 0 day per week; group 2, performing 1-3 days per week; group 3, performing 4-5 days per week; group 4, performing 6-7 days per week. BMI, body mass index; BP, blood pressure; eGFR, estimated glomerular filtration rate; GGT, γ-glutamyltransferase; LDL, lowdensity lipoprotein.